Port Wine Stains

Port-wine stains (PWS) are an abnormal development of blood vessels in the skin. These birthmarks are present at birth and occur in about 3 out of 1,000 people. Port-wine stains appear most often on the face, but can appear anywhere on the body. They vary in size, but are usually flat and pink in appearance. As the patient matures, the color may deepen to a dark red or purplish color. At various stages of life, these purple, pink, or red stains can actually thicken and become raised.

The presence of port-wine stains can cause emotional and social problems for the affected person because of their cosmetic appearance. Port-wine stains that involve the upper and lower lids (trigeminal distribution) may be associated with the development of glaucoma. PWS may be one of a group of symptoms present with a particular syndrome such as Sturge-Weber syndrome or Klippel-Trenaunay-Weber syndrome.

Laser surgery has become the treatment of choice for port-wine stains, because they are capable of destroying the cutaneous capillaries without significant damage to the skin. The flashlamp pumped dye laser, the Scleroplus Pulse Dye Laser and the Versapulse Yag Laser have all been successful at destroying stains in infants and young children. Two other yellow light lasers, the copper vapor and krypton laser, have been used successfully in adults. The neodymium-YAG laser is used to treat thick, nodular, deep purple port-wine stains. Stains on the face respond better than those on the trunk or limbs. Older stains may be more difficult to treat. The earlier treatment begins, the better the results since, as they mature, port-wine stains become more difficult to treat. Younger children are generally treated under sedation. Older children and adults are treated with a topical numbing cream. The treatment is usually well tolerated as the lasers have a chilling mechanism that cools the skin during the treatment and reduces discomfort. Bruising or swelling may occur and should fade within 7-10 days. Patients should expect to take 10 or more treatments with a 1-2 month period between sessions to completely treat a port-wine stain.